Organization Active NPI

Story Road Therapy

  • Marriage & Family Therapist
  • Southfield, MI
National Provider Identifier
1164206116
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
Legal business name
STORY ROAD THERAPY
Practice address
29551 Greenfield Rd Ste 212
Southfield, MI 48076-5872
Phone
(248) 221-2718
NPI assigned
Aug 22, 2023
Last updated
Aug 22, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Marquitta Fields, LMFT
Title
Owner
Phone
(248) 221-2718

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X NU Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X NU

Addresses

Primary practice location

29551 Greenfield Rd Ste 212
Southfield, MI 48076-5872

Mailing address

29551 Greenfield Rd Ste 212
Southfield, MI 48076-5872
Phone (248) 221-2718

National Provider Directory

National Provider Directory

Locations

29551 Greenfield Rd
Ste 212
Southfield, MI 48076
Phone (248) 221-2718

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692662400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1692662400000",
    "number": "1164206116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29551 GREENFIELD RD STE 212",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765872",
            "telephone_number": "248-221-2718"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29551 GREENFIELD RD STE 212",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765872",
            "telephone_number": "248-221-2718"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STORY ROAD THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-22",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A",
        "authorized_official_last_name": "FIELDS",
        "authorized_official_first_name": "MARQUITTA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "248-221-2718",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southfield, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.